Multisensory Training for Hemianopia

Overseen By Benjamin A Rowland, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Wake Forest University Health Sciences

Must not be taking: Safety-influencing drugs

Disqualifiers: Major medical problems, Neurological disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 64 weeks

72 Participants Needed

Trial Summary

What is the purpose of this trial?

This study seeks to determine the extent of the visual capabilities that can be restored in hemianopic stroke patients by a multisensory training technique and evaluate changes in the brain that the training induces. The effectiveness of the technique will be evaluated in two interventional contexts: patients whose blindness is long-standing and stable, and another in which intervention is as soon as possible after the stroke.

Will I have to stop taking my current medications?

The trial does not specify if you must stop taking your current medications, but it excludes those taking medication that could negatively influence safety during the intervention. It's best to discuss your specific medications with the study team.

What data supports the effectiveness of the treatment Multisensory Training for Hemianopia?

Research shows that multisensory training, which combines visual and auditory stimuli, helped two patients with hemianopia (blindness on one side) regain the ability to see and describe visual stimuli in their blind field within weeks. This suggests that the treatment can quickly and effectively restore visual function in hemianopia. ^{1 2 3 4 5}

Is multisensory training safe for humans?

The studies on multisensory training for hemianopia in humans do not report any safety concerns, suggesting it is generally safe. The training involves visual-auditory stimulation and has shown improvements in visual function without adverse effects. ^{1 2 6 7 8}

How does multisensory training differ from other treatments for hemianopia?

Multisensory training for hemianopia is unique because it uses a combination of visual and auditory stimuli to stimulate the brain's multisensory pathways, which can help restore vision in the blind field. Unlike other treatments, this approach leverages the brain's ability to integrate different sensory inputs, leading to rapid and long-lasting improvements in visual function. ^{1 2 6 7 9}

Research Team

Benjamin A Rowland, PhD

Principal Investigator

Wake Forest University Health Sciences

Eligibility Criteria

Adults over 18 with stable homonymous hemianopia for at least 6 months, or new cases less than a month old. Participants must speak English, be cognitively normal, have reliable transportation, and be MRI compatible. Exclusions include current major medical issues affecting cognition or vision, substance abuse, other neurological disorders like dementia or Parkinson's disease.

Inclusion Criteria

I have been diagnosed with vision loss on the same side of both eyes for over 6 months.

Can safely undergo an MRI scan.

You are able to do daily activities without a problem, or a recent test showed that your memory and thinking are normal.

Exclusion Criteria

A doctor has not excluded me from the study due to stroke symptoms.

I am on medication that may not be safe with the trial treatment.

I do not have major health issues affecting my thinking, sight, or ability to attend study visits.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive multisensory or unisensory training depending on their group assignment

64 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

Treatment Details

Interventions

• Multisensory Training
• Unisensory Training

Trial Overview The trial is testing multisensory training to improve vision in patients with blindness caused by stroke. It compares the effectiveness of this technique on those with long-standing blindness versus those recently affected.

Participant Groups

Group I: Standard Intervention: Multisensory Training Experimental Treatment 1 Intervention

Patients with stable hemianopia (\>6 months) are given multisensory training

Group II: Early Intervention: Multisensory Training Experimental Treatment 1 Intervention

Patients with early hemianopia (\<1 months) are given multisensory training

Group III: Standard Intervention: Unisensory Training Active Control 2 Interventions

Patients with stable hemianopia (\>6 months) are given auditory training and crossover to multisensory training

Group IV: Early Intervention: Unisensory Training Active Control 2 Interventions

Patients with early hemianopia (\<1 months) are given auditory training and crossover to multisensory training

Who Is Running the Clinical Trial?

Wake Forest University Health Sciences

Lead Sponsor

Trials

1,432

Recruited

2,506,000+

Findings from Research

Visual-auditory stimulation therapy has shown promising results in restoring visual sensitivity in two male patients with hemianopia, a condition typically considered permanent after stroke, with significant improvements observed within a few weeks.

Both patients were able to detect, describe, and localize visual stimuli in their previously blind field, demonstrating that this multisensory approach can effectively enhance visual function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ameliorating Hemianopia with Multisensory Training. Rowland, BA., Bushnell, CD., Duncan, PW., et al.[2023]

A novel approach using passive auditory stimulation significantly improved visual detection in patients with hemianopia, showing nearly a 100% increase in performance shortly after stimulation on the blind side.

The improvement in visual detection was temporary, lasting about 1.5 hours, suggesting that auditory stimulation may activate residual visual pathways, highlighting a potential new method for rehabilitation of visual field disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Passive auditory stimulation improves vision in hemianopia. Lewald, J., Tegenthoff, M., Peters, S., et al.[2021]

In a study of 21 patients with hemianopia, 4 weeks of compensatory visual field training significantly improved their ability to detect and react to visual stimuli when using exploratory eye movements, with these improvements lasting for 8 months.

Despite the training enhancing visual detection and reaction times, the actual size of the visual field defect (scotoma) did not change, indicating that the training improved functional abilities without restoring the lost visual field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Compensatory visual field training for patients with hemianopia after stroke. Nelles, G., Esser, J., Eckstein, A., et al.[2022]

A cohort study involving 19 patients (7 with neglect and 12 with neglect and hemianopia) showed that 10 sessions of multisensory audio-visual stimulation significantly improved clinical signs of neglect, with these improvements lasting for months after training.

The study suggests that the benefits of this training may be linked to activity in subcortical structures like the superior colliculus, which play a role in integrating sensory information and spatial orientation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioural and functional changes in neglect after multisensory stimulation. Làdavas, E., Tosatto, L., Bertini, C.[2022]

A new rehabilitation approach using audio-visual stimulation showed promising results in improving visual field defects in 8 patients, with training sessions lasting 4 hours daily over nearly 2 weeks.

Patients demonstrated significant improvements in visual detection and oculomotor exploration, which translated to better performance in daily activities, with benefits lasting up to one month after treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual search improvement in hemianopic patients after audio-visual stimulation. Bolognini, N., Rasi, F., Coccia, M., et al.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Ameliorating Hemianopia with Multisensory Training. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Passive auditory stimulation improves vision in hemianopia. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Multitasking Compensatory Saccadic Training Program for Hemianopia Patients: A New Approach With 3-Dimensional Real-World Objects. [2023]

4. Ireland pubmed.ncbi.nlm.nih.gov

Compensatory visual field training for patients with hemianopia after stroke. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Eye-Search: A web-based therapy that improves visual search in hemianopia. [2018]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Compensatory Recovery after Multisensory Stimulation in Hemianopic Patients: Behavioral and Neurophysiological Components. [2020]

7. England pubmed.ncbi.nlm.nih.gov

Behavioural and functional changes in neglect after multisensory stimulation. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Cross-modal exposure restores multisensory enhancement after hemianopia. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Visual search improvement in hemianopic patients after audio-visual stimulation. [2019]